Treatment of tissue with radiant energy
Devices and methods for utilizing electromagnetic radiation and other forms of energy to treat a volume of tissue at depth are described. In one aspect, a device modulates the flux incident on surface tissue to control and vary the depth in the tissue at which an effective dose of radiant energy is delivered and, thereby, treat a specific volume of tissue. The methods and devices disclosed are used to perform various treatments, including treatments to relieve pain and promote healing of tissue.
1 . A method of treating tissue, comprising:
irradiating a portion of tissue with EMR having a first input flux;
determining whether said subject has experienced a sensation of heating within said portion of tissue; and
irradiating said portion of tissue with EMR having a second input flux higher than said first input flux, if said subject has not experienced a sensation of heating in response to said first input flux.
2 . The method of claim 1 , further comprising irradiating said portion of tissue with EMR having a second input flux lower than said first input flux when said subject has experienced a sensation of heating in response to said first input flux.
3 . The method of claim 1 , further comprising repeating the steps of determining and irradiating with said second input flux until said subject experiences a sensation of heating within said portion.
4 . The method of claim 1 , wherein said sensation of heating is reported by said subject.
5 . The method of claim 1 , wherein said sensation of heating is detected by a sensor.
6 . The method of claim 1 , wherein said sensation of heating corresponds to a highest level of irradiation that can be applied without causing damage to said tissue.
7 . The method of claim 1 , wherein said sensation corresponds to approximately a highest level of irradiation that said subject can tolerate without requiring cooling of said tissue.
8 . The method of claim 1 , wherein said sensation of heating corresponds to a highest level of stimulation that can be applied without causing a sensation of pain.
9 . The method of claim 1 , further comprising irradiating said portion of tissue at a maximum input flux for a first duration of time, wherein said maximum input flux corresponds to the input flux applied when said subject reports a sensation of heating.
10 . The method of claim 9 , wherein said duration corresponds to an amount of time that said maximum input flux can be applied without causing a sensation of severe pain in said subject.
11 . The method of claim 9 , wherein said duration corresponds to an amount of time that said maximum input flux can be applied without causing damage to said portion of tissue.
12 . The method of claim 9 , further comprising irradiating said portion of said tissue at a reduced input flux for a second duration of time, wherein said decreased input flux is less than said maximum input flux.
13 . The method of claim 12 , wherein said reduced input flux is approximately 10% lower than said maximum input flux.
14 . The method of claim 12 , wherein said reduced input flux is approximately 20% lower than said maximum input flux.
15 . The method of claim 12 , further comprising irradiating said portion of said tissue using a series of reduced input fluxes, wherein each of said reduced input fluxes is less than said maximum input flux.
16 . The method of claim 1 , further comprising cooling said portion of said tissue.
17 . The method of claim 1 , wherein said second input flux is approximately in the range of two to three times the first input flux.
18 . The method of claim 1 , wherein said first input flux is in the range of approximately 0.1 watts/cm 2 to 0.6 watts/cm 2 .
19 . The method of claim 1 , wherein said second input flux is in the range of approximately 0.2 watts/cm 2 to 1.8 watts/cm 2 .
20 . A method of treating pain in a subject, comprising:
irradiating a portion of tissue of said subject with EMR having a first intensity;
determining whether said subject has experienced a decrease in said pain; and
irradiating said portion of tissue with EMR having a second intensity lower than said first intensity after said subject has experienced a decrease in said pain.
21 . The method of claim 20 , wherein said step of irradiating with EMR having a first intensity further comprises irradiating said portion until said subject experiences a sensation of heat within said tissue.
22 . The method of claim 20 , wherein said step of irradiating with EMR having a first intensity further comprises irradiating said portion until said subject experiences a sensation of heat throughout said tissue.
23 . The method of claim 20 , wherein said step of irradiating with EMR having a first intensity further comprises irradiating said portion until said subject experiences an intense sensation of heat within said tissue.
24 . The method of claim 20 , wherein said step of irradiating with EMR having a first intensity further comprises irradiating said portion until said subject reports a sensation of heat in said tissue.
25 . The method of claim 20 , wherein said step of irradiating with EMR having a first intensity further comprises irradiating said portion until said subject reports a sensation of heat throughout said tissue.
26 . The method of claim 20 , wherein said step of irradiating with EMR having a first intensity further comprises irradiating said portion until said subject reports an intense sensation of heat within said tissue.
27 . The method of claim 20 , wherein said first intensity is greater than approximately 0.1 watts/cm 2 .
28 . The method of claim 20 , wherein said first intensity is selected from the range of approximately 0.8 watts/cm 2 to approximately 1.6 watts/cm 2 .
29 . The method of claim 20 , wherein said second intensity is less than approximately 0.6 watts/cm 2 .
30 . The method of claim 20 , wherein said second intensity is greater than approximately 0.1 watts/cm 2 .
31 . The method of claim 20 , wherein said second intensity is selected from the range of approximately 0.4 watts/cm 2 to approximately 0.8 watts/cm 2 .
32 . The method of claim 20 , wherein said first intensity does not damage said portion of tissue.
33 . The method of claim 20 , wherein said second intensity does not damage said portion of tissue.
34 . The method of claim 20 , further comprising waiting for a period of time between irradiating with said first intensity and irradiating with said second intensity.
35 . The method of claim 34 , wherein said period of time is greater than one hour.
36 . The method of claim 20 , further comprising irradiating said portion of tissue of said subject with EMR having a third intensity that is greater than said first intensity.
37 . The method of claim 36 , wherein said step of irradiating with said third intensity is performed if said subject does not experience a decrease in pain in response to said first intensity.
38 . The method of claim 20 , further comprising irradiating said portion of tissue of said subject with EMR having a third intensity that is greater than said second intensity.
39 . The method of claim 38 , wherein said step of irradiating said portion with said third intensity is performed after said step of irradiating said portion with said second intensity.
40 . The method of claim 38 , further comprising:
determining whether said subject has experienced an increase in said pain;
wherein said step of irradiating with said third intensity is performed after said subject has experienced an increase in said pain.
41 . The method of claim 38 , wherein said third intensity is substantially equal to said first intensity.
42 . The method of claim 20 , wherein said pain is chronic pain.
43 . The method of claim 20 , wherein said pain is acute pain.
44 . The method of claim 20 , wherein said portion of tissue is irradiated with said first intensity at a first location and said portion of tissue is irradiated with said second intensity at a second location.
45 . The method of claim 44 , wherein said first location is a doctor's office.
46 . The method of claim 44 , wherein said second location is a residence.
47 . The method of claim 20 , wherein said portion of tissue is irradiated with said first intensity using a first device and said portion of tissue is irradiated with said second intensity using a second device.
48 . The method of claim 47 , wherein said first device is a professional device.
49 . The method of claim 47 , wherein said second device is a consumer product.
50 . The method of claim 20 , further comprising storing input data for a set of parameters for use in subsequent applications of EMR.
51 . The method of claim 50 , wherein said input data is stored automatically.
52 . A method of treating tissue, comprising:
irradiating said tissue with EMR at a first input flux; and
irradiating said tissue with EMR at a second input flux;
wherein said first input flux is greater than said second input flux.
53 . The method of claim 52 , wherein said first input flux is greater than approximately 0.1 watts/cm 2 .
54 . The method of claim 52 , wherein said first intensity is selected from the range of approximately 0.8 watts/cm 2 to approximately 1.6 watts/cm 2 .
55 . The method of claim 52 , wherein said second input flux is less than approximately 0.6 watts/cm 2 .
56 . The method of claim 52 , wherein said second input flux is greater than approximately 0.1 watts/cm 2 .
57 . The method of claim 52 , wherein said second intensity is selected from the range of approximately 0.4 watts/cm 2 to approximately 0.8 watts/cm 2 .
58 . The method of claim 52 , wherein said first input flux does not damage said tissue.
59 . The method of claim 52 , wherein said second input flux does not damage said tissue.
60 . The method of claim 52 , further comprising waiting for a period of time between irradiating with said first input flux and irradiating with said second input flux.
61 . The method of claim 60 , wherein said period of time is greater than one hour.
62 . A method of treating tissue comprising
irradiating a portion of tissue of a subject with a fluence of electromagnetic radiation;
increasing the fluence of the radiation applied to the tissue portion; and
adjusting the increased fluence such that an optimal fluence is achieved,
whereby the fluence is maximized at a level below that where the subject experiences a sensation of heating.
63 . A method of treating pain in a subject, comprising
irradiating a portion of tissue of a subject with electromagnetic radiation having an intensity sufficient for the patient to experience a decrease in pain;
decreasing the intensity of the radiation applied to the tissue portion; and
adjusting the decreased intensity such that an optimal intensity is achieved,
whereby the intensity is minimized at a level where the subject still experiences a decrease in pain.